Psoriasis is yet another chronic condition that may affect the face.  It more commonly affects the scalp and extends from the scalp down onto the face.  Psoriasis is uncommon in young children frequently first appearing in mid to late teens and carrying on through life.

Psoriasis is an hereditary condition resulting from on overproduction of skin cells. This causes the affected areas of skin to become red, scaly and itchy.  The most distinctive symptom of psoriasis is the thick, silver scales that develop on the skin over the rash.

There is no cure for psoriasis.  Treatment is aimed at controlling the symptoms.  Warm, moist conditions tend to improve psoriasis hence many psoriasis sufferers will move to warmer climates where they are able to enjoy an outdoors life.

Treatments range from topical creams through to internal and ultraviolet light therapies.  Mild cases are usually managed quite effectively by avoiding environmental triggers and using topical creams.  More severe cases often require a variety of different treatment options being used in conjunction.  Close medical guidance is therefore needed in these cases.

Rosacea is a chronic condition affecting the blood vessels of the face.  It is most common in both men and women aged between 30 and 40 and results in red blotches with hard swollen pimple like bumps appearing on the face.

The superficial facial blood vessels become enlarged and dilated resulting in the hot, inflamed rash that is common in rosacea.  Rosacea is most common in people who are prone to blushing and is triggered by any condition that will cause the blood vessels to dilate.

Treatment is therefore aimed at avoiding conditions that will cause dilatation of the superficial facial blood vessels.  These conditions include:
•    Stressful, anxious or embarrassing situations
•    Allowing the skin to overheat (sauna’s, sunburn, overcrowded rooms, washing in hot water)
•    Some medications and foods (always consult your doctor before using a new medication)

It is also important to remember that rosacea is not related to eczema or acne and the treatments normally used for these conditions may worsen rather than improve the symptoms.  Treatment is aimed at treating symptoms and avoiding trigger situations.

The most common health problem after musculo-skeletal problems is dermatitis or eczema.  This is not surprising when the average adult has 21 square feet (2 square metres) of skin that weighs 3.2 kg (7 pounds) and has approximately 300 million skin cells.

Contact Dermatitis

Approximately 29% of industrial health problems are contact dermatitis.  This is probably higher as many people suffer from the condition without knowing.  Most people work with their hands and this is usually the first area affected by contact dermatitis.  Other exposed areas such as the face and neck may also be involved.

Atopic Eczema

Another form of eczema is atopic eczema, which is the most common form of eczema.  It is rare to be born with the condition however it commonly develops at about 2-3 months.  Fortunately many children will grow out of it but for some with severe eczema it will continue through into their teens and even adult life.

The majority of children will only have mild eczema by the time they start school.  On average half of the children with eczema should be much improved by school age and three-quarters by their teens.  There is always the possibility of a flare up even after years of normal skin.

The head may only take up a small proportion of the body but if there is a problem at the top end it can affect everything.  Eczema of the scalp is a very common problem, and the associated itchiness can drive you mad.

There are two basic forms – that which affects adults known as Adult Seborrheic Eczema and that which affects children known as Infantile Seborrheic Eczema.

Adult seborrheic eczema

This eczema usually affects adults between the ages of 20 and 40.  Seborrheic eczema tends to develop gradually and begins with itching and scaliness of the scalp which becomes red and inflamed.  It is similar to dandruff except the scale is more marked and the scalp becomes inflamed.

Sufferers of eczema of the scalp will often find that it may spread down to the face, in particular the oily zones such as the sides of the nose, eyebrows and ears.  It may even extend to the central chest area.

Seborrheic eczema affects areas with large amounts of oil glands.  The body reacts to a yeast on the scalp resulting in the inflammation.

Most sufferers of seborrheic eczema will be especially sensitive to chemicals in products such as soaps, bubble baths and some shampoos and cosmetics.  These can dry out the scalp even more and thus create an increasingly embarrassing dandruff problem. When selecting a suitable shampoo it is important to find one designed for sensitive skin that is free from the harsh chemicals.

Infantile seborrheic eczema (Cradle Cap)

A common eczema condition affecting babies usually less than 12 months of age.

Cradle cap usually starts on the scalp or the nappy area and spreads to areas where the skin rubs together like the elbows or under the armpits. This type of eczema features red, scaly patches and looks unpleasant, but it usually is not sore or itchy.  Most cradle cap clears by the time the baby is 12 months old.

“I’ve heard that children under 12 months should not have honey.  Is Calendulis Plus Cream safe for my baby when it has manuka honey in it?”

This is a question I get asked often.  And the answer is:

As a general rule children under the age of 12 months should not ingest raw honey because honey may contain clostridium botulinum spores.  The spores do not germinate in the adult digestive system because it is acidic.

However they may germinate in the gut of young infants because they do not have well developed intestinal flora.  Cases of botulism disease, even in children are extremely rare.

The Calendulis Plus Cream is suitable for children and babies because the manuka honey used is for external use only and therefore never enters the digestive system.

When applying the Calendulis Plus Cream avoid the eyes and mouth and ensure the cream is fully rubbed in.  Even if your baby sucks on the skin where the cream has been recently applied he will not be able to digest any.

One of the most important things you can do for your skin, especially when you have eczema is to keep it well moisturised.  Applying a good moisturiser atleast once a day is vital to keeping dry skin moist and supple and to help reduce flareups.

We often forget of the other simple way of keeping our skin moist – hydrate from the inside.  It’s as simple as that.  Drinking 8 – 10 glasses of water a day has many benefits for the body. If you hydrate your body you hydrate your skin in the process.

It is important that when drinking 8 -10 glasses of water a day you ensure that it is water and not just fluid that you are drinking as some fluids (ie coffee, alcohol and sugary drinks) act as a diuretic and can actually dehydrate the body and skin rather than hydrate it.

Eczema and psoriasis are both inflammatory conditions of the skin.  The best way to understand these conditions and how to care for them is to learn as much as possible about them.  As a start it is a good idea to go right back to the basics and learn about the skin itself.

The Human Skin

As in other mammals, human skin is composed of an outer layer, the epidermis, and an underlying layer of fibrous tissue called the dermis. Beneath the dermis is the subcutaneous fat.

There are two main kinds of human skin; Glaborous skin (non-hairy skin) and hair-bearing skin. Glaborous skin is found on the palms and soles and is characterised by a thick epidermis with dermatoglyphics (fingerprints).

Hairy skin differs from site to site, for example, the scalp versus the arm. It also contains a wide range of other structures depending on the part of the skin examined. Nails are formed from the epidermis on the fingers and toes. Oil glands (sebaceous glands) are found attached to hair follicles.  Sweat glands are found in the dermis with ducts passing to the surface through the epidermis.

One of the most complex organs

In certain areas such as the axilla and groin there are specialised sweat glands called apocrine glands which develop after puberty. In addition there are specialised sense organs and nerves, blood vessels and other tissues such as muscle, which make the skin one of the most complex organs in the body.

The epidermis is constantly growing from the bottom upwards and the dead skin cells (stratum corneum) are shed (usually invisibly) from the surface. This whole process normally takes about 52-75 days but can be much quicker in some skin diseases such as psoriasis.

Some Quick Facts

• The average adult has 21 square feet of skin (2 sq m) which weighs 7lb (3.2 kg) and has approximately 300 million skin cells.

• On average each square half inch of skin contains: 10 hairs, 15 sebaceous glands, 100 sweat glands, 3.2 feet (1m) of tiny blood vessels.

• Skin is thickest on the palms & soles (1.2mm to 4.7mm) and thinnest on the lips and around the eyes. Facial skin is approximately 0.12mm thick and onthe body is about 0.6mm.

Have you noticed an increasing trend for men today to have facial hair?  Whether it be the popular 3 day growth, a little goatie or the full on beard, facial hair is on the increase.

I wonder if the men with the facial hair give a thought to the women obliged to kiss them. The delicate facial skin of these women is destined to suffer.

“Chafing, eczema or acne brought on by beards isn’t that uncommon,” says dermatologist Hema Sundaram, and she warns that facial burns that bleed might require antibiotics.

The dry, itchy, inflamed skin characteristic of atopic eczema almost always starts in infancy.  Infact 10% of all children in the USA under the age of 5 years are believed to have eczema.  The condition alternately worsens and improves.  During flare-ups the dry skin may crack leading to open weeping or crusted sores.

It is thought that 60% of children who get eczema will have it by the age of 2 years and 90% will have it by the age of 5 years.  50% of children with eczema will develop asthma or hayfever later in life.

Although not contagious research indicates that atopic eczema like other atopic conditions is genetically determined.  The chances of developing atopic eczema are significantly increased when one or both parents suffer from an atopic condition.  However 30% of all people affected with eczema have no family member with any of the allergic disorders.

Psoriasis is an inherited skin condition affecting thousands of adults and children worldwide.  The condition causes an over production of skin cells resulting in an excess of immature cells on the skin’s surface.

Psoriasis features dry, thick, red patches of skin with silvery scales.  It is most common on the elbows, knees, scalp and torso.  A scratch, illness or even stress may cause the condition to flare up.  There is no cure for psoriasis so the condition must be treated constantly to be kept under control.

“There is a great deal of itching and a lot of embarrassment because of the very dramatic appearance of skin lesions,” said dermatologist Dr Rebedah Oyler.

Choosing the right treatment for your psoriasis is not easy and will often require consultation with your doctor.  Some medications may cause damage to the liver or kidneys.

The safest form of treatment for moderate to severe psoriasis is phototherapy although long term use still carries some risks, mainly of skin cancer.  In phototherapy the ultra violet light calms the response of the immune system to the skin which causes the outbreaks.

“The light box machines are calibrated so that we know exactly how much light energy the person is receiving,” Dr Oyler said.

Of course the new range of probiotic medications are also effective in treating moderate to severe psoriasis.  Although approved for use the long-term side effects of these drugs are still not fully known, as they are still very new to the market.

If you have moderate to severe psoriasis discuss the side effects of the chosen treatment options with your doctor so that you are able to make an educated decision regarding your choice of treatment.